Aside

Contact Info

Skills

Experienced in statistical analysis, hypothesis testing, predictive analytics, exploratory data analysis, experimental design, healthcare analytics, financial forecasting and budgeting.

Languages and Tools

End-to-End R Skills

Statistics

Main

Brian Muir, PhD

Highly-inquisitive team-leader with 11+ years of experience employing machine learning and statistics in the healthcare industry and in computational biology. Direct the forecasting of $10+ billion in pharmacy and medical claim expenses using advanced predictive models in R for Centene Corporation’s (Fortune 500) marketplace insurance LOB.

Education

University of California Riverside

Ph.D. in Evolution, Ecology & Organismal Biology

Riverside, CA

2016 - 2010

Boston College

B.S. in Biology, Psychology (Double Major)

Chestnut Hill, MA

2010 - 2006

Professional Experience

Director - Marketplace Forecasting

Centene Corporation / Actuarial Services

Chicago, IL

Current - May, 2020

Manager - Analytics & Reporting

Centene Corporation / Actuarial Services

Chicago, IL

May, 2020 - Jul, 2018

  • Direct the development, implementation, and presentation of the forecast for medical expenses across 27 states using mixed-models regression.
  • Lead a team of six actuaries and data analysts with diverse experience and backgrounds.
  • Developed strong relationships with various technical and non-technical business partners by supporting analytics with team’s in-depth knowledge of company’s medical, pharmacy, provider, membership, health status, sales, and payment data.
  • Present findings to leadership on member-segmented variances to forecast, financial impacts of COVID cost and deferral of services, and deep-dives into claims trends during monthly CFO financial briefings.
  • Developed a member-level gross margin database detailing revenue and expense components across 40 targetable member characteristics that integrates disparate data sources using SQL/R. Deployed overlaying drill-down dashboard in RSConnect used widely across departments to identify risks and opportunities for member-segmented business actions.
  • Identified and support an $8M annual initiative improving on risk adjustment code capture by data-mining pharmacy prior authorization data.
  • Created stratified med-management targeting model based on interacting utilization and health status, disease management acceptance, and demographics.
  • Developed a member-level gross margin database detailing revenue and expense components across 40 targetable member characteristics that integrates disparate data sources using SQL/R. Deployed overlaying drill-down dashboard in RSConnect used widely across departments to identify risks and opportunities for member-segmented business actions.
  • Identified and support an $8M annual initiative improving on risk adjustment code capture by data-mining pharmacy prior authorization data.

Data Scientist I

Centene Corporation / Business Optimization

Chicago, IL

Jul, 2018 - Oct, 2017

Data Analyst II

Centene Corporation / Business Optimization

Chicago, IL

Oct, 2017 - Sep 2016

  • Built and implemented a novel claims completion model using regression to estimate incurred-but-not-reported expenses prior to month end. Model is used for early-warning and to accelerate preparation of financial reporting and commentary.
  • Developed a probabilistic outlier-detection model based on episodes of care that is used to highlight targets for quality and cost-saving initiatives.
  • Designed enterprise’s primary care auto-assignment algorithm to optimally assign members to local providers identified as high-quality and low-cost.
  • Devised Rx trends and top conditions interactive RMarkdown reports using automated commentary to highlight emerging trends in Rx utilization; present findings monthly to Pharmacy Directors of local health plans.

Research Experience

Graduate Research Assistant / Computational Biology

University of California Riverside

Riverside, CA

Sep, 2010 - Aug, 2016

  • Analyzed large gene expression datasets with R (Bioconductor) using non-parametric statistical models.
  • Performed statistical tests of codon evolution in cancer gene-sequence alignments using maximum likelihood models.
  • Designed and directed a multi-year longitudinal experimental evolution study on fruit flies that employed advanced experimental design statistics. Oversaw 2 – 6 undergraduate volunteer research assistants per quarter.
  • Taught 18 quarters of upper and lower division biology courses with up to 150 students per week. Mentored 2 – 6 undergraduate volunteer research assistants per quarter.

Publications and Presentations

The expression of tumour suppressors and proto-oncogenes in tissues susceptible to their hereditary cancers.

Muir, B. & Nunney, L. British journal of cancer, 113(2), 345-353.

N/A

2015

Peto’s paradox and the hallmarks of cancer: constructing an evolutionary framework for understanding the incidence of cancer.

Nunney, L. & Muir, B. Phil. Trans. R. Soc. B, 370(1673), 20150161.

N/A

2015

Presentations

Scientific Conferences

N/A

2014-2015

  • International Biannual Evolution and Cancer Conference - Lightning Talk & Poster | 2015
  • Evolution Conference - Talk | 2014

Exams & Awards

Exams

Society of Actuaries

N/A

2018-

  • PA - Predictive Analytics | Jun 2019
  • SRM - Statistics for Risk Modeling | Jan 2019
  • P - Probability | Sep 2018

Awards

Research and Education

N/A

2010-2016

  • GAANN Fellowship | U.S. Department of Education | 2016
  • Outstanding Teaching Assistant | UCR Graduate Division | 2015
  • Dissertation Year Fellowship Award | UCR | 2015
  • Chancellor’s Distinguished Fellowship Award | UCR | 2010